ELSO 2025 Narrative Guideline on ECMO Training and Continuing Education

Perfusfind S.L.
Guías clínicas Jan 1, 1970 0

Abstract

Disclaimer: 

These guidelines are intended for educational use to build the knowledge of physicians and other health professionals in assessing the conditions and managing the treatment of patients undergoing extracorporeal life support (ECLS)/ECMO and describe what are believed to be useful and safe practice for ECLS and ECMO. The aim of clinical guidelines was to help clinicians to make informed decisions about their patients. However, adherence to a guideline does not guarantee a successful outcome. Healthcare professionals must make their own treatment decisions about care on a case-by-case basis, after consultation with their patients, using their clinical judgment, knowledge, and expertise. These guidelines do not take the place of physicians’ and other health professionals’ judgment in diagnosing and treatment of patients. These guidelines are not intended to and should not be interpreted as setting a standard of care or being deemed inclusive of all proper methods of care nor exclusive of other methods of care directed at obtaining the same results. The ultimate judgment must be made by the physician and other health professionals and the patient considering all the circumstances presented by the individual patient, and the known variability and biologic behavior of the clinical condition. These guidelines reflect the data at the time the guidelines were prepared; the results of subsequent studies or other information may cause revisions to the recommendations in these guidelines to be prudent to reflect new data, but ELSO is under no obligation to provide updates. In no event will ELSO be liable for any decision made or action taken in reliance upon the information provided through these guidelines.

Since the publication of the Position Paper on Global ECMO Education in 2019,1 there has been a four-fold increase in publications related to extracorporeal membrane oxygenation (ECMO) education, with many studies describing original curricula and educational interventions delivered using simulation, traditional didactics, online modules, and other multimedia.2 Although this growth in ECMO educational scholarship mirrors the growing utilization of ECMO worldwide, particularly for adult and pediatric populations, there remains significant variability in educational practices across Extracorporeal Life Support Organization (ELSO) centers.3 Although survival rates in the ELSO registry have remained relatively unchanged, and complication rates remain high,4 this may, in part, reflect the increasing complexity of cases being treated. Nonetheless, the opportunity and need for consensus-driven, standard curriculum and competency assessment remain clear.

Multiple gaps inherent to ECMO education have historically made the worldwide adoption of a competency-based education framework challenging. First, ECMO practitioners are healthcare professionals with specialized training who demonstrate competencies in patient selection, circuit management, patient management, troubleshooting, and emergency response.1 These practitioners come from diverse disciplines and have varying core skills and roles. As a result, creating a uniform assessment is challenging for both ECMO specialists (eg, nurses, respiratory therapists, perfusionists, or other ECMO-trained providers managing the circuit and bedside care) and ECMO physicians (eg, intensivists, cardiologists, surgeons, neonatologists, or anesthesiologists overseeing patient care and decision-making). Second, ECMO instructor development lacks a formalized process and defined milestones for transmitting high-quality information and valuable expertise. Third, competency-based assessment and certification processes are inconsistent across ECMO training centers.5 Lastly, with a growing recognition that time-based training may not yield competent ECMO practitioners, educators are primed to clearly define desired programmatic outcomes, design curricula that facilitate the attainment of those outcomes, and establish programs of assessment to measure the extent to which those outcomes have been achieved.

The ELSO has introduced several guidelines to predefine educational objectives, including training guidelines for ECMO centers, ECMO Specialists, and certification programs, such as the ELSO-Adult ECMO Certification (E-AEC) and ELSO-Neonatal Pediatric ECMO Certification (E-NPEC).6,7 These are early steps toward standardization and require further refinement to align with best practices in medical education. Reflecting efforts to reduce variability in ECMO training worldwide, where educational preparation and prior professional experience differ substantially across regions and disciplines, ELSO has developed an international, consensus-driven ECMO education curriculum, identified essential technical skills for troubleshooting ECMO emergencies, and created a standardized assessment of minimum competency. Extracorporeal Life Support Organization is updating its guidelines for ECMO education to establish a globally recognized, competency-based framework.

Purpose

The revised Guideline for Training and Continuing Education aims to:

  • Align ECMO education with evidence-based instructional methodologies.
  • Define minimum standards for initial and ongoing ECMO training and instructor development.
  • Define standardized processes for assessment and certification of ECMO practitioners.

The guideline integrates best practices in simulation, debriefing, and adult learning principles to create a standardized and scalable ECMO education model. The goal is to promote a consistently high standard of ECMO care that reduces variability in ECMO training, provides centers with an essential, competency-based ECMO education framework, and ultimately leads to improvements in patient outcomes worldwide.

Read the full guideline

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